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General NPI Number Information
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NPI Number | 1376970368
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Entity Type | Organization
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Legal Business Name | MASON BILLINGSLEA ENTERPRISES, LLC
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 5401 S KIRKMAN RD SUITE 207
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City | ORLANDO
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State | FL
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Zip | 32819-7940
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Country | US
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Telephone | 407-617-3352
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1037
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City | WINDERMERE
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State | FL
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Zip | 34786-1037
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEIDRE P BILLINGSLEA
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Credential |
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Telephone | 407-617-3352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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